The Effectiveness of Therapeutic Exercise on Motor Skills and Attention of Male Students with Autism Spectrum Disorder
Autism spectrum disorders (ASD) involve myriad aberrant perceptual, cognitive, linguistic, and social behaviors. The term spectrum emphasizes that the disabilities associated with ASD fall on a continuum from relatively mild to severe. People with ASD may display stereotyped behaviors such as twirling, spinning objects, flapping the hands, and rocking. The individuals with ASD exhibit communication problems due to repetitive/restricted behaviors. Children with ASD who lack the motivation to learn, who do not enjoy physical challenges, or whose sensory perception results in confusing or unpleasant feedback from movement may not become sufficiently motivated to practice motor activities. As a result, they may show both a delay in developing certain motor skills. Additionally, attention is an important component of learning. As far as children with ASD have problems in joint attention, many education-based programs are needed to consider some aspects of attention and motor activities development for students with ASD. These programs focus on the basic movement skills that are crucial for the future development of the more complex skills needed in games, dance, sports, gymnastics, active play, and recreational physical activities. The purpose of the present research was to determine the effectiveness of therapeutic exercise on motor skills and attention of male students with ASD. This was an experimental study with a control group. The population consisted of 8-10 year-old male students with ASD and 30 subjects were selected randomly from an available center suitable for the children with ASD. They were evaluated by the Basic Motor Ability Test (BMAT) and Persian version of computerized Stroop color-word test and randomly assigned to an experimental and control group (15 students in per group). The experimental group participated in 16 therapeutic exercise sessions and received therapeutic exercise program (twice a week; each lasting for 45 minutes) designed based on the Spark motor program while the control group did not. All subjects were evaluated by BMAT and Stroop color-word test after the last session again. The collected data were analyzed by using multivariate analysis of covariance (MANCOVA). The results of MANCOVA showed that experimental and control groups had a significant difference in motor skills and at least one of the components of attention (correct responses, incorrect responses, no responses, the reaction time of congruent words and reaction time of incongruent words in the Stroop test). The findings showed that the therapeutic exercise had a significant effect on motor skills and all components of attention in students with ASD. We can conclude that the therapeutic exercise led to promote the motor skills and attention of students with ASD, so it is necessary to design or plan such programs for ASD students to prevent their communication or academic problems.
 DSM-V APA. Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishin. 2013, http://www.psychiatry.org/psychiatrists/practice.dsm.
 S. Kirk, J. J. Gallagher, R. M. Coleman, Educating Exceptional Children. 14 ed. United States of America: Cengage Learning; 2015, ISBN-13: 978-1285451343
 D. D. D. Sandt, G. C. Frey, Comparison of physical activity levels between children with and without autistic spectrum disorders. Adapted Physical Activity Quarterly. 2005; 22(2): 146-59. doi: http://doi.org/10.1123/apaq.22.2.146
 D. Hallahan, J. Kauffman, P. Pullen, Exceptional Learners: An Introduction to Special Education. 12 ed.: Pearson Education, Inc.; 2013, ISBN-978-0137033706.
 Autism, Investigators DDMNSYP. Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2010. Morbidity and Mortality Weekly Report: Surveillance Summaries. 2014; 63(2): 1-21.
 D. Mandell, L. Lecavalier, Should we believe the Centers for Disease Control and Prevention’s autism spectrum disorder prevalence estimates? Sage Publications Sage UK: London, England; 2014. Doi: https://doi.org/10.1177/1362361314538131
 S. A. Samadi, A. Mahmoodizadeh, R. A. McConkey, National study of the prevalence of autism among five-year-old children in Iran. Autism. 2012; 16(1): 5-14. doi: https://doi.org/10.1177/1362361311407091
 S. J. Blumberg, M. D. Bramlett, M. D. Kogan, L. A. Schieve, J. R. Jones, M. C. Lu, Changes in Prevalence of Parent-Reported Autism Spectrum Disorder in School-Aged US children: 2007 to 2011-2012. National Center for Health Statistics Reports. Number 65. National Center for Health Statistics. 2013. http://www.cdc.gov/nchs
 M. Pourmohamadreza-Tajrishi, B. Rajabi-Shamami, H. Haghgoo, The Pivotal Response Training (PRT) in children with Autism Disorder. Journal of Exceptional Education. 2013; 8(121): 56-61. http://exceptionaleducation.ir/article-1-230-en.html
 M. Balconi, A. Carrera, Emotional representation in facial expression and script A comparison between normal and autistic children. Research in Developmental Disabilities. 2007; 28(4): 409-22, doi: https://10.1016/j.ridd.2006.05.001 (PubMed:16828156)
 C. Hilton, K. Graver, P. LaVesser, Relationship between social competence and sensory processing in children with high functioning autism spectrum disorders. Research in Autism Spectrum Disorders. 2007; 1(2): 164-73. doi: https://doi.org/10.1016/j.rasd.2006.10.002
 J. L. Matson, T. J. Dempsey, Stereotypy in Adults with Autism Spectrum Disorders: Relationship and Diagnostic Fidelity. Dev Phys Disabil 2008; 20(2): 155-65. doi: https://doi.org/10.1007/a10882-007-9086-0
 M. Lloyd, M. MacDonald, C. Lord, Motor skills of toddlers with autism spectrum disorders. Autism. 2013; 17(2): 133-46. doi: https://10.1177/1362361311402230 (PubMed:21610184).
 D. L. Gallahue, J. Goodway, J. C. Ozmun, Understanding motor development: infants, children, adolescents, adults. New York: McGraw-Hill; 2012, http://trove.nla.gov.au/version/166268758
 G. T. Baranek,. Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders. 2002; 32(5): 397-422. (PubMed:12463517), ISSN:0162-3257.
 C-Y. Pan, Age, social engagement, and physical activity in children with autism spectrum disorders. Research in Autism Spectrum Disorders. 2009; 3(1): 22-31. doi: https://doi.org/10.1016/j.rasd.2008.03.002.
 D. Dewey, M. Cantell, S. G. Crawford, Motor and gestural performance in children with autism spectrum disorders, developmental coordination disorder, and/or attention deficit hyperactivity disorder. Journal of the International Neuropsychological Society: JIN: 13(2): 246-56. doi: https://10.1017/s1355617707070270 (PubMed:17286882)
 R. Lang, L. K. Koegel, K. Ashbaugh, A. Regester, W. Ence, W. Smith, Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders. 2010; 4(4): 565-76. doi: https://doi.org/10.1016/j.rasd.2010.01.006
 F. J. Sansosti, Using video modeled social stories to increase the social communication skills of children with high functioning autism/Asperger’s syndrome (Graduate Theses and Dissertations): University of South Florida; 2005, http://scholarcommons.usf.edu/etd/847.
 S. Hemmati, R. Vameghi, F. Sajedi, M. Gharib, M. Pourmohamadreza-Tajrishi, R. Teymori, The Effect of Neurofeedback on Brain Waves in Children with Autism Spectrum Disorders. Iranian Rehabilitation Journal. 2016; 14(3): 133-8. doi: https://10.18869/nrip.irj.14.3.133
 F. Torabi, A. Aghayari, S. Dashtabadi, The Effect of Basic Swimming Skills Training on Gross Motor Skills in Autistic Children (7-11 Years Old). Journal of Motor Learning and Movement. 2015; 7(2): 171-85. doi: https://10.22059/jmlm.2015.55249
 F. Keyhani, S. Kosari, The effect of a period of physical activity on the development object control skills in high function autism children’s (HFA). Motor Behavior. 2015; 6(18): 103-16. http://mbj.ssrc.ac.ir/article 234 a4a33e1e8077ba6611c93be0c3d470f1.pdf
 A. Prupas, G. Reid, Effects of Exercise Frequency on Stereotypic Behaviors of Children with Developmental Disabilities. Education and Training in Mental Retardation and Developmental Disabilities. 2001; 36(2): 196-206. http://www.jstor.org/stable/23879735
 S. L. Berkeley, L. L. Zittel, L. V. Pitney, S. E. Nichols, Locomotor and object control skills of children diagnosed with autism. Adapted Physical Activity Quarterly. 2001; 18(4): 405-16, ISSN: 0736-5829.
 S. M. Clifford, C. Dissanayake, The early development of joint attention in infants with autistic disorder using home video observations and parental interview. Journal of Autism and Developmental Disorders. 2008; 38(5): 791-805. doi: https://10.`007/a10803-007-0444-7
 T-Y. Wang, H-C. Huang, The performance on a computerized attention assessment system between children with and without learning disabilities. Procedia-Social and Behavioral Sciences. 2012(64): 202-8. http://ir.lib.kuas.edu.tw/handle/987654321/13896
 B. Rajabi Shamami, M. Pourmohamadreza-Tajrishi, H. Haghgoo, A. Vosouqi, A. Biglarian, The Effect of Pivotal Response Training (PRT) on Behavioral Problems of 4-6 years Old Children with Autism. Journal of Rehabilitation. 2014; 14(6): 50-8. http://rehabilitationj.uswr.ac.ir/article-1-1395-en.html
 A. Poursadoughi, A. Dadkhah, M. Pourmohamadreza-Tajrishi, A. Biglarian, Psycho-Rehabilitation Method (Dohsa-Hou) and Quality of Life in Children with Cerebral Palsy. Iranian Rehabilitation Journal. 2015; 13(2): 28-33. http://irj.uswr.ac.ir/article-1-432-en.html
 D. Arnheim, W. A. Sinclair, D. Arnheim, S. Sinclair, The basic motor ability test-Revised. In The clumsy child. 2nd ed.:Louis Mosby; 1979. P.119-144. ISBN:ASIN: B000Y0FAHy
 C. L. Hung, Y. K. Chang, Y. S. Chan, C. H. Shih, C. J. Huang, T. M. Hung, Motor ability and inhibitory processes in children with ADHD: a neuroelectric study. Journal of Sport & Exercise Psychology. 2013; 35(3): 322-8. doi: https://doi.org/10.1123/jsep.35.3.322 (PubMed:23798594)
 L. A. Kurtz, Understanding motor skills in children with dyspraxia, ADHD, autism, and other learning disabilities: A guide to improving coordination. Jessica Kingsley Publishers; 2007. ISBN: 1846426723
 P. Moghim Islam, M. Pourmohamadreza-Tajrishi, H. Haghgoo, The Effect of Reciprocal Imitation Training on Social Skills of Children with Autism. Journal of Rehabilitation. 2014; 14(6): 59-67 http://rehabilitationj.uswr.ac.ir/article-1-1409-en.html.
 D. M. Wolpert, M. S. Landy, Motor control is decision-making. Current Opinion in Neurology. 2012; 22(^): 996-1003. doi: https://doi.10.1016/j.conb.2012.05.003
 E. Bremer, R. Balogh, M. Lloyd, Effectiveness of a fundamental motor skills intervention for 4-year-old children with autism spectrum disorder: A pilot study. Autism. 2015; 19(8): 980-91. doi: https://10.1177/1362361314557548 (PubMed:25432505)